When we enter medical school, we bring with us high hopes, dreams, ambition and a passion to help those in need. We radiate vibrant energy and have an insatiable thirst for knowledge. In many ways, we represent some of the best and brightest of what humanity has to offer. Yet, it is common to hear how many medical students feel stressed, disheartened and burnt out at some point in their training to become altruistic healers. I, too, was one of many among my peers at my medical school to go through such trials; however, my situation was more than ordinary.
Prior to embarking on a career path into medicine, I had experienced periods of mood disturbances, in which I physically and mentally shut down and laid lifelessly in my room for days. During these moments, I suffered from symptoms like psychomotor retardation, leaden paralysis and hypersomnia, to name just a few. It wasn’t until I got older and entered medical school that those episodes increased in frequency and severity, the symptoms ultimately becoming unmanageable. I learned about DSM5 sitting in my neuroscience class and it dawned on me that all these years I was struggling with mental illness. I started reflecting on days when I showed up at the student clinic adamant about having the nurse check my vitals because I swore I had dizziness and shortness of breath; I was oblivious, unable to decipher that I was having a panic attack.
I never sought help prior to medical school because my grades never suffered, and I, like many, fell into the trap of judging my wellbeing based on my academic performance. Therefore, I didn’t take the symptoms I experienced throughout my teenage and pre-medical years seriously. Nor did I let my parents in on my little secret, because I didn’t want to be another burden. It didn’t help that I was raised in a culture where mental illness is taboo and looked upon as something to conceal and be ashamed about. Even after experiencing glimpses of my condition in my preclinical years, I continued to ignore my symptoms because I believed that I would be able to bear them, just like I always had. Although my grades didn’t suffer in medical school and I was fortunate enough to successfully pass all of my classes, my psyche took all the blunt hits. My depression spiraled out of control and eventually consumed me, leaving me functionally debilitated. I was diagnosed with complicated major depressive disorder and generalized anxiety disorder. After my fourth medication failed, I naturally lost faith and felt trapped in a cycle of hopelessness.
Depression for me felt like the emotional pain and torture that one would feel if he/she lost an immediate family member; except, in my case, I was emotionally and physically paralyzed without losing anyone or anything. Objectively speaking, my life was actually going great; I was a young bright girl in medical school with extremely loving and supportive parents and friends who adore me. Yet I continued to suffer internally, especially as the likelihood of being completely healed with an antidepressant seemed far from reality. I began to realize the treatment of mental illnesses for most people is actually a grueling process of trial and error; this required much patience and strength on my part to endure. I have been able to successfully battle my depression and anxiety due to the extensive support system I have garnered: family, friends, doctors, therapists and school mental health counselors. Most of all, I forced myself to practice positivity, which allowed me to extract passion from my unfortunate circumstance and turn such a negative experience into a purpose to do greater good.
Depression and anxiety are no longer a secret for me. While I have suffered greatly, I have also grown in many ways because of my illness. The silver lining that I learned to embrace as I fought these intangible diseases hold quite the irony. Previously, to learn the art of medicine, I memorized a grid of questions and practiced being a healer with my standardized patients, but it was my own illness that became one of my primary teachers. It took being a patient again to revive the passion I once had for medicine and to garner the insight of those living with mental illness. Feeling the pain of being inflicted with an illness, when I was training to be a doctor myself, was quite a wake-up call. My battle with depression and anxiety forced me to disconnect from the accolades of being a medical student and humanized me to experience what it is like to feel helpless and to be at the mercy of good clinicians. Being a patient will continue to truly be the best teacher in many ways when it comes to learning care and compassion in the field of medicine.
Today, I refuse to let depression defeat me or to steal from me the dreams and aspirations I always held so tightly in my heart. My desire to pursue medicine has become strengthened as I repeatedly learn firsthand the importance of primary care. According to the National Institute of Mental Health, there were nearly 1 in 5 Americans living with any diagnosable mental disorder within the year 2015. Among those numbers, 1 in 25, like myself, have serious functional impairment due to mental illness. Even the youth are afflicted, as approximately 20% of children between ages 13 and 18 currently have or previously had a seriously debilitating mental disorder. All of these alarming statistics emphasize the fact that mental health is one of the chief medical and societal issues of our time, which must be addressed in this generation. It also highlights the urgency of making the extra effort as providers to inquire about the mental health of our patients and to be alert in looking for all the physical symptoms that could possibly signal underlying problems. Although I learned about the routine management and treatment for fatigue, headaches and chronic back pain from textbooks, it was due to my own personal experience that I am again taught to remember that, as a future physician, my profession centers around thinking of my patients’ health holistically. My endeavor is to treat my patients and not just symptoms of a disease.
In all honesty, my depression and anxiety have helped me to not only become a better physician in the future, but also a more compassionate person in general. No longer is mental illness a weakness in my eyes. Instead, I have learned to transform the fragmented pieces of myself into a pillar of strength and motivation. This newly reignited vigor that I have learned to harness from an unlikely circumstance will propel me into becoming a more patient-centered provider. It is important to remember that we are all human and, as humans, we will all be broken at some point in time — no matter what profession we practice. It is also the human survivor in us that will continue to fight and strive to find that corresponding positive among the negatives. It is a scientific fact that the energy of the universe moves toward equilibrium; as such, it is always possible for us to find balance in our life. I dream to help construct a future where mental illness is rid of all stigma and mental health care is more accessible for everyone. I hope to raise awareness and inspire others with my story. Fighting an invisible disease like mental illness is no easy feat, but resilience is powered by perspective and achieved through effort.
Mastering an MD with MDD: An Initiative to Destigmatize Mental Illness in Medicine
I am just a medical student who happens to suffer from complicated major depressive disorder and generalize anxiety disorder. The statistics all say that medical students and physicians are more prone to mental illness, but not many of us come out and share our mental health issues candidly. This column emerged out of my need to voice for change. I see no shame in starting the conversation and opening up about my journey through medical school with mental illness. Through this column, I hope to reach out to my fellow students who are enduring similar struggles, demonstrating to them that they are not alone and that it is perfectly possible to be a successful physician even with mental illness. In addition, I would like to offer a unique perspective to those who cannot relate in order to create more understanding about each other within the medical field. The stigma surrounding mental illness in medicine may not have started with us, but it can certainly end with us if we collectively rise up, raise awareness and demand change. As a famous revolutionary once stated, “Be the change you wish to see in the world.” I wish to follow in his footsteps.